In coronary artery disease, cholesterol is deposited in walls of coronary arteries due to family history of heart disease, abnormal cholesterol or blood pressure, diabetes, smoking, excess weight and high fat blood.
In most patients, the first sign is sudden heart attack or death due to the cholesterol plaque in the wall of the artery suddenly rupturing or breaking loose. On contact with underlying tissue, blood in the artery clots or forms a thrombosis (or blood clot) that blocks the artery, thereby causing the heart attack.
Removing the cholesterol deposit from the wall of the artery by intense medical management (ex. Medications) reduces the risk of plaque rupture and heart attack.